Digital Arts Classes Spring 2023
This form will register your child for Classes at Palama Settlement! One form per child.

Spring session runs from January 9th to May 19th

A follow up email will be sent after this form is submitted! :)
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Email *
Our Spring 2023 schedule at a glance....
What class(es) would you like to sign up your child for? (elementary school ages) *
Required
What class(es) would you like to sign up your child for?  (Ages 10 to 15) *
Required
What class(es) would you like to sign up your child for? (High School Ages) *
Required
Participant Information
This section will ask you information about the child you're signing up!
Participant's First Name *
Participant's Last Name *
Participant's Age *
Participant's Gender *
Participant's Grade *
Participant's Birthday *
MM
/
DD
/
YYYY
Home Phone Number *
Address *
Zip Code *
School name *
Does the participant have any medical conditions that we should be aware of? (ie. Asthma, Diabetes, seizures, heart problems, food allergy, drug allergies etc) *
Required
If yes, please provide information, and list any medications being taken.
Physician Name *
Physician Phone Number *
Medical Insurance Carrier *
Policy/Membership Number *
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